School Holiday Camps - Parklands Sports Centre

0 downloads 119 Views 231KB Size Report
Full Camp - $220 weekly OR $190 4 days (TICK). December: Monday 11th – Friday 15th. December: Monday 18th – Thursday
School Holiday Camps Registration Form Full Camp - $220 weekly OR $190 4 days (TICK) December: Monday 11th – Friday 15th December: Monday 18th – Thursday 21st January: Monday 8th – Friday 12th January: Monday 15th – Friday 19th January: Monday 22nd – Thursday 25th Single Days - $60 per day (TICK) Camp One: Mon Camp Two:

Tues

Wed

Thurs

Fri

Tues

Wed

Thurs

Fri

Mon

Tues

Wed

Thurs

Fri

After camp care 3pm – 5:30pm - $20 per day

Registration Information Child’s Full Name: Address: Suburb:

Postcode:

Parent/Guardian Information Full Name:

D.O.B

Email:

Currently having lessons Y/N:

Contact Numbers:

Work: Home: Mobile:

Any particular dietary requirements, health related needs or pre-existing injuries, astma or known allergies? Yes

No

If yes, please provide further detail below (ie. E.Pen.Ventolin etc.)

_______________________________________________________________________________ • • • • • •

Centennial Parklands Sports Centre wishes to advise that patrons using facilities do so at their own risk. Centennial Parklands Sports Centre carries Public Liability Insurance only. For personal injury you are advised to join a medical health fund of your choice. $50.00 deposit is required to secure your child’s place is non-refundable. Balance must be paid by first day of camp. Centennial Parklands Sports Centre staff have been screened under the governments’ Working with Children’s Check and will supervise children at all specified times during the School Holiday Camps (8.30am – 3.00pm) each day. I give permission for my child to cross the road from Moore Park Golf to Parklands Sports Centre. I give permission for my child to be included in group photos from the Camp. These may or may not be used on social media.

In case of an emergency, I give Centennial Parklands Sports Centre staff permission to attend to the aid of my child and call ambulance assistance is necessary at my own expense. I understand and accept all of the above conditions. Name: (Parent/Guardian): __________________________________________________________________ Signature: __________________________________________________

Date: ______/______/ 2017